Wellness on the Menu

Hospital food has arguably long been in desperate need of a makeover. So when UC Davis Health had ambitions to overhaul its cuisine, they called a chef who was no stranger to cooking for large crowds: Santana Diaz.

Diaz, a native of California’s Central Valley, had already successfully implemented a “farm-to-fork” ethos at Super Bowl 50 and the Golden 1 Center, home of the Sacramento Kings, alongside other culinary projects. The chef’s deep belief in the transformative power of food informed the design of a first-of-its-kind meal program at UC Davis, built around the idea that “good food is good medicine.”

Diaz launched the initiative on joining UC Davis in 2018 and today, he says, the hospital’s kitchen serves more than 6,700 nutritious meals to its patients and staff daily. The institution does so by partnering with local, mostly organic and regenerative farms in the Central Valley, reviving a community of growers that has experienced decline in recent decades due to factors like rising costs, climate change, and aggressive competition in a global market.

Here, Diaz speaks with The Rooted Journal about UC Davis Health’s farm-to-fork program, the importance of seasonality and supporting local farmers, and the future of America’s food landscape.

THE ROOTED JOURNAL Tell me a bit about your background and how your upbringing informed your interest in the culinary world.

SANTANA DIAZ I grew up in Yuba City, an agro-town that is a producer of a lot of stone fruits about an hour north of Sacramento. My family immigrated from Mexico and worked in the fields harvesting; my mother became a teacher, my aunt became a nurse, and my grandfather and uncle were farmers. I’ve always been around fresh fruit and seasonal food. With that upbringing came an expectation of certain foods to taste a certain way, not having to manipulate seasonal food because it’s already at its peak ripeness.

I always worked in restaurants and ended up going to culinary school. I then went into fine dining and wanted to take that quality of food to the masses. So I just started going to bigger entities, like Hyatt Hotels and Omni Hotel Resorts in San Francisco, and then was asked to go to stadiums to increase the quality of their food programs. Levi’s Stadium came into the picture, then Super Bowl 50, and eventually I wanted to come back home to Sacramento. The opportunity to open the Golden 1 Center for the Kings came up so I did that. The next challenge was seeing if we could do a farm-to-fork program in a hospital, which was what the leadership at UC Davis Health was trying to accomplish. The answer, six-and-a-half years later, is yes. We’ve done it.

TRJ At what point in your career did you recognize the importance of seasonality when it comes to ingredients?

SD As a society, we’ve gotten desensitized to seasonality because we go into our grocery stores and tomatoes are always in the same part of our produce section all year round. We know they taste better at different times of the year, but we still buy them in winter. If we invite guests over for grilled burgers on a nice day in December, we’ll still have the same lettuce, tomatoes, and onions on that sandwich.

As I looked at larger entities, I started paying more attention to how we were sourcing. Sourcing in larger quantities and wanting to serve ingredients that were fresher — not just chicken fingers and fries — led me to looking at what was abundant.

TRJ Did that prove to be simple to do or challenging?

SD Well, it was deeper than just straight sourcing. Looking at Sacramento, family farms that grow seasonally just don’t exist anymore. Farmers were sending their children to higher education to learn to do something else. I asked myself why. When I started connecting the dots, I realized that communication wasn’t always there between the market and what someone was growing. A farmer can be growing produce or raising cattle blind and not sure if there’s going to be an end buyer. So at the end of a season when their product is ready to harvest or their cattle is ready to sell, that farmer might not have realized that there are others growing or raising the same thing; now, the market is saturated and that farmer is broke. That cycle isn’t sustainable for a family.

So when I started in the large-capacity venues and the hospital, I realized that those relationships with farmers and ranchers are very important, and to help them guarantee an end buyer ensures that I will have quality, in-season ingredients to serve. As one example, through UC Davis we’ve helped secure sustainable, organic asparagus for our region through a partnership with Durst Organic Growers in Yolo County. They are able to grow a little more than what we commit to and provide to many restaurants here in the region. Without our secured forecasts, it would be difficult for them to compete with Mexico’s prices. We need institutions for so many things, but it’s also the way they can help other businesses as a byproduct or help the community and, in this case, help people who want to eat something that’s locally grown.

TRJ How does designing hospital meals differ from restaurant dishes?

SD Hospital food has always had the stigma of not being very good. Hospitals will use computer systems to analyze the nutritional value and density of a given meal. But what the system doesn’t tell you is that the meal is all beige or that it doesn’t even taste good, just that it’s satisfying a diet’s parameters. I don’t think it was done on purpose; the focus was just elsewhere.

Our approach at UC Davis was about introducing that culinary-trained eye, which is all based on flavor profiles and aesthetic appeal.

Traditionally, the food has been served via a conveyor belt-style plating system. But part of what we’re rolling out now is a true room-service plan for patients where we’re putting the love and care back into every meal by having the cook plate each dish just as a restaurant would.

And all the menu items have been thought through. For example, I like to have a minimum of four colors on a plate. As for nutrition, we’re combining ingredients through a system that measures how much magnesium or phosphorus, etc., is in each dish, and then we put all of that together in a way that’s mindful, aesthetically pleasing, and with good flavor profiles that people will enjoy so they actually consume the nutrients — which is the point of the program in the first place.

TRJ From the perspective of UC Davis, was the investment in this initiative significant?

SD This was one of the first conversations I had with leadership. I said, “If it was cheap and easy everyone would do it.” Everybody’s already doing the cheap and easy thing, which is why we’re seeing the issues we have today.

When talking about sustainability and why it’s important, one of the lightbulb moments for me came when I was thinking about what it takes to design a high-end dinner menu at a hotel for 400 people. If you’re serving everyone an ounce of filet mignon, do the math and you’ll need 250 pounds of beef tenderloin. That’s a lot of cows. How is that sustainable? Instead, why not connect with the rancher and say, “Hey, what are you long on? What’s in your freezer?” He might say, “I have these beef back ribs and I’m sitting on 3,500 pounds.” So, why don’t I just generate a menu out of that?

Basically, I don’t like to tell the farmers what to grow. I ask the farmers what they grow, and then try to figure out how to use that item. That’s really when both of us get to use our skills to the best of our ability.

TRJ How do you think about a balanced day of meals for a patient in the hospital?

SD My menus are approved by dietitians, but it doesn’t matter what the hospital provides if the patient never eats it, right? If it doesn’t taste good and the patient doesn’t eat it, they’re not receiving the nutrition they need to heal and food isn’t being used as medicine in that case.

Can we also give some autonomy back to the patient? As a patient you come to a hospital, you’re admitted, tested, moved around, and in many cases you’re just happy to be seen. What would it mean to you if you had the opportunity to choose the meals that you eat while you’re here? If I order a meal, I’m more likely to eat it.

In terms of what a meal looks like, it’s what the person wants to eat that also aligns with their diet — and if we can make that taste great, then awesome.

The other thing we’re paying attention to is being culturally accurate with the meals we’re providing. That really goes another layer deeper. We never want to shame a patient’s existing diet or recipes that may be family ones. We may suggest an alternative version of the recipe that we’ve used and share why it may align better with the path a patient is on in respect to their diet. That communication is important to us.

TRJ What are your criteria for selecting ingredients and farming partners?

SD We try to get whatever produce is closest first. We ask farmers if they’re adopting organic or regenerative practices. We explore if they have certifications that verify some of this and how long they’ve been in business. Do they actually own their farm or is this just an overarching entity corporation? And then of course we’re looking at the volume they can provide. It’s also important that we try not to be the sole buyer for any one farm because if we had to make a change for whatever reason, we wouldn’t want that farm to go out of business. I don’t look to buy more than 40% from any one farmer or rancher.

TRJ What would you say makes the food and ingredients that come out of California unique to this region?

SD The bounty of this region is so fruitful. It’s sort of like a food mecca. But does it look like that in 20 years? I don’t have an answer. The choices we make now on our regional sourcing will determine that future.

If local institutions do not secure ingredients here, what’s to stop other countries from just growing everything we grow here? If California continues to be put up on the world market stage, it cannot compete financially. How is the California farmer supposed to survive?

TRJ Would you say that local support is key in securing a healthy, thriving future for food in this country?

SD These are big questions that I’ve thought a lot about. I’m not trying to preach politics but rather advocate for transparency. I won’t name names, but does that organic berry that you see in the plastic clamshell in your grocery store undergo the same scrutiny as a California organic farmer? There are a lot of questions like that that come up for me when I visit the grocery store.

How is it that a university in California is able to import beef from Australia at a better rate than California-raised beef? These are concerning issues. I’m confident that 95% of what we order is beef that comes from California — organic where possible and from regenerative ranches to minimize the impact of greenhouse emissions and how far your food has traveled. But how do you compete against meat you can buy from another country, have shipped across oceans, and go through so many people and checks along the way, that’s still cheaper than buying from the farmer 35 miles up the road? It’s a question of priorities, I think.

TRJ What advice would you give to someone with ambitions of bringing positive, systemic change to their own organization or industry?

SD Don’t undervalue the power of a sandwich. It sounds funny, but where are all those ingredients coming from? Know your farmers and where your food comes from. I know you hear that all the time but it’s a real thing. And understand that “dollar vote.” Where we spend our money is what we’re choosing to support.

TRJ One last question. What’s your favorite single ingredient from the Central Valley?

SD I just love tomatoes. They’re so versatile. I eat them until I get tomatoed out for the season.